RESIDENT/HUMANITARIAN COORDINATOR REPORT ON THE USE OF CERF FUNDS YEAR: 2019 RESIDENT/HUMANITARIAN COORDINATOR REPORT ON THE USE OF CERF FUNDS SOUTH SUDAN RAPID RESPONSE EBOLA 2019 19-RR-SSD-33820 RESIDENT/HUMANITARIAN COORDINATOR ALAIN NOUDÉHOU REPORTING PROCESS AND CONSULTATION SUMMARY a. Please indicate when the After-Action Review (AAR) was conducted and who participated. 10 October 2019 The AAR took place on 10 October 2019, with the participation of WHO, UNICEF, IOM, WFP, and the Ebola Secretariat (EVD Secretariat). b. Please confirm that the Resident Coordinator and/or Humanitarian Coordinator (RC/HC) Report on the Yes No use of CERF funds was discussed in the Humanitarian and/or UN Country Team. The report was not discussed within the Humanitarian Country Team due to time constraints; however, they received a draft of the completed report for their review and comment as of the 25 October 2019. c. Was the final version of the RC/HC Report shared for review with in-country stakeholders (i.e. the CERF recipient agencies and their implementing partners, cluster/sector coordinators and members and relevant Yes No government counterparts)? The final version of the RC/HC report was shared with CERF recipient agencies and their implementing partners, as well as with cluster coordinators and the EVD Secretariat, as of 16 October 2019. 2 PART I Strategic Statement by the Resident/Humanitarian Coordinator South Sudan is considered to be one of the countries neighbouring the Democratic Republic of Congo (DRC) at highest risk of Ebola importation and transmission. Thanks to the allocation of USD $2.1 million from the Central Emergency Relief Fund Ebola preparedness in South Sudan, including the capacity to detect and respond to Ebola, has been strengthened. Through the efforts of the International Organization of Migration, the United Nations International Children’s Emergency Fund, the World Food Programme, the World Health Organization and their implementing partners, and under the overall leadership of the Ministry of Health and the Ebola National Task Force, South Sudan now has more frontline workers with the knowledge to identify and report suspected Ebola cases. Health centres, markets, schools, churches, and mosques have better access to clean water, bathrooms, and handwashing stations. Communities living in high risk areas near the border with the DRC and Uganda understand how to identify Ebola and what to do in the event that they find a suspected case. Screening sites have been established along the border, and screening is obligatory for all passengers travelling into the country. Through this generous support from the CERF, I am confident that South Sudan is now much better prepared to identity, manage and contain an outbreak should there one occur within its borders. 1. OVERVIEW TABLE 1: EMERGENCY ALLOCATION OVERVIEW (US$) a. TOTAL AMOUNT REQUIRED FOR THE HUMANITARIAN RESPONSE 11,568,822 FUNDING RECEIVED BY SOURCE CERF 2,015,164 COUNTRY-BASED POOLED FUND (if applicable) 1,603,421 OTHER (bilateral/multilateral) 12,949,786 b. TOTAL FUNDING RECEIVED FOR THE HUMANITARIAN RESPONSE 16,568,371 TABLE 2: CERF EMERGENCY FUNDING BY PROJECT AND SECTOR (US$) Date of official submission: 14/01/2019 Agency Project code Cluster/Sector Amount IOM 19-RR-IOM-002 Health - Health 349,997 Water Sanitation Hygiene - Water, Sanitation and UNICEF 19-RR-CEF-005 528,792 Hygiene WFP 19-RR-WFP-002 Common Support Services - Common Logistics 119,493 WHO 19-RR-WHO-003 Health - Health 1,016,882 TOTAL 2,015,164 3 TABLE 3: BREAKDOWN OF CERF FUNDS BY TYPE OF IMPLEMENTATION MODALITY (US$) Total funds implemented directly by UN agencies including procurement of relief goods 1,801,537 Funds transferred to Government partners* 0 Funds transferred to International NGOs partners* 173,627 Funds transferred to National NGOs partners* 40,000 Funds transferred to Red Cross/Red Crescent partners* 0 Total funds transferred to implementing partners (IP)* 213,627 TOTAL 2,015,164 * These figures should match with totals in Annex 1. 2. HUMANITARIAN CONTEXT AND NEEDS The Democratic Republic of Congo (DRC) is still grappling with the world’s second largest Ebola epidemic on record, more than a year since the Ministry of Health of the Democratic Republic of Congo (DRC) reported the Ebola Virus Disease (EVD) outbreak in North Kivu province, the 10th Ebola outbreak in DRC since the virus was first discovered in 1976. The response efforts have been complicated by the ongoing conflict which exacerbates the risks and makes it more complex to prevent and treat the disease. It is estimated that over one million people are internally displaced in the affected areas of DRC and the epicentre of the outbreak is a target for non-state armed actors, resulting in challenges due to insecurity and community resistance. As of 16 October 2019, about 3,224 EVD cases (link) had been reported in DRC, of which 2,152 died (case fatality ratio 67.1 per cent). The risk of the EVD spreading into the neighbouring countries remains high. In neighbouring states, three cases of Ebola have been confirmed in Uganda as of June 2019 and there are unsubstantiated reports of suspected cases in Tanzania. Also in July, an Ebola case was reported in Ariwara in the DRC, close to the border with South Sudan. South Sudan has experienced three indigenous outbreaks of EVD, in 1976, 1979 and 2004, indicating that even without the risk of EVD importation from the DRC, the country harbours reservoirs of EVD and shares many of the same characteristics as the endemic locations in the DRC. An estimated 2.87 million people in 22 counties of South Sudan are considered as being at risk of EVD based on geographic proximity to the current hot spots reporting EVD cases in DRC, and patterns of population movement to and from those locations. Based on a WHO joint monitoring mission for EVD preparedness and readiness that took place from 15-19 November 2018, South Sudan is rated as a ‘Priority 1’ country for EVD preparedness and readiness. The mission was led by WHO and UNICEF in cooperation with the Republic of South Sudan Ministry of Health and other key stakeholders. The mission report made strategic and operational recommendations for enhancing EVD preparedness and response. Based on these findings, an initial National Ebola Preparedness Plan, covering a period of six months through to March 2019, was developed under the leadership of WHO and MoH encompassing six strategic ‘pillars’, each with respective objectives. CERF funding was requested in order to contribute to the full implementation of this plan and to support UN Agencies and their respective partners to ensure delivery of the most time-critical and highest priority preparedness activities. About 227,140 people in the high-risk counties are across Kajo Keji, Juba, Yei, Magwi, Torit, Ezo, Maridi, Nagero, Nzara, Tambura, and Yambio are at immediate risk due to the proximity to Democratic Republic of Congo. The transmission of the virus into South Sudan will however expose the close to 12 million people in South Sudan to the risk of Ebola infection. CERF funding was critical to the implementation of the initial National Ebola Preparedness Plan which required US$16,333,093. The CERF contributed to the increase in the coverage of preparedness activities in the prioritized locations and critical boost against the total requirement of the National Ebola Preparedness Plan. Coordinated efforts from the government and humanitarian partners have improved the level of EVD preparedness, with the establishment of screening sites, training of health workers, awareness raising, procurement of essential supplies and coordination structures, among others. However, the South Sudan’s health system is still fragile, from the combined effects of chronic and widespread conflict and insecurity, including large scale-internal displacement, attacks on/destruction of health 4 facilities, limited access to health services for populations in need, shortages of skilled health workers, high attrition of available health workers, and high inflation rates that have negatively impacted on the capacity of the country to pay its health workers. With the Ebola Virus Disease outbreak still active in DRC, the risk of transmission to South Sudan and the neighbouring countries is still high. Strengthening of existing health infrastructure and sustained awareness raising is required, especially given the geographic proximity to the provinces in DRC experiencing the current outbreak, the volume of travel and trade, and the previous history of EVD in the country. Seven states are still assessed to be at highest risk of transmission, namely Gbudwe, Jubek, Maridi, Tambura, Torit, Wau, and Yei River. 3. PRIORITIZATION PROCESS Following the EVD outbreak declaration in DRC in August 2018, and in view of the high-risk rating of the outbreak spreading into South Sudan, the Minister of Health visited the states identified as at greatest risk to provide leadership and support for EVD preparedness activities. A coordination and leadership structure was established including (a) a National Task Force (NTF) and State Task Forces (STF) led by the Ministry of Health (MoH); (b) Technical Working Groups (TWG) for selected pillars of the EVD preparedness strategy led by relevant technical partner agencies (noted below); and (c) a Strategic Advisory Group (SAG) led by WHO and constituted by UN agencies, key humanitarian partner agencies and donors. WHO was appointed as Incident Manager to coordinate EVD preparedness activities and provide leadership and guidance to the NTF and SAG. On the 19 December 2018, OCHA convened a SAG meeting and attended by representatives of implementing UN Agencies as well as the wider coordination architecture to identify the priority activities within the framework and pillars of the National Ebola preparedness plan and taking into consideration gaps in funding and level and criticality of the activities to EVD preparedness.